AB1418 A SYSTEMATIC REVIEW OF CURRENT RHEUMATOLOGY GUIDELINES FOR GERIATRIC PERSPECTIVES
Authors: B. Bitik, M. E. Tezcan, A. E. Yucel
Journal: Annals of the Rheumatic Diseases (2022)

Background Geriatric population (GP) includes people over 65 years of age. GP can also be divided into the 65-75 age group and &gt;75 age group. In the last 50 years, the proportion of the elderly in the society has increased (1). Meanwhile, GP has higher frequency of rheumatological disorders. While managing the treatment of this special patient group, some physiological differences of the elderly should be considered. Elderly patients are at increased risk for adverse drug reactions as a result of age-related changes in pharmacokinetics and pharmacodynamics. Polypharmacy is contributing to increased risk of clinically significant drug interactions. In addition, alterations in cognitive functions may impair drug compliance. On the other hand, clinicians may hesitate to apply more effective treatment due to safety concerns. (2).Rheumatologists should be aware of the problems they may encounter when planning the treatment of this privileged group. Objectives We reviewed rheumatology guidelines to assess rheumatology organizations’ perspective on GP. Methods Guidelines published by EULAR, ACR and the British Society for Rheumatology (BSR) for adult patients from 1970-2022 were reviewed by two rheumatologists to assess the existence of specific recommendations for the treatment of adult patients over 65 years of age. Results In total, 58 guidelines were reviewed. None of the guidelines grouped patients by age. Seven (12%) guidelines had recommendations or statements about elderly patients (Table 1). As we observe, there are no satisfactory recommendations for the GP with rheumatological diseases. The most propable reason for this result is the lack of studies in the rheumatology literature to lead to guideline recommendations. Table 1. Characteristics of guidelines reviewed Number of guidelines (n ) Guidelines with specific recommandation for GP EULAR 38 1-2-3-4-5-6 ACR 11 6 BSR 9 7 1 EULAR points to consider for the management of difficult-to-treatrheumatoidarthritis(recommendation 6) 2 . Points to consider for the development, evaluation and implementation of mobile health applications for self-management in patients with rheumaticdiseases (points to consider 8) 3 . 2019 update of EULAR recommendations for Vaccination in AdultPatientswithAutoimmuneInflammatoryRheumatics 4 . EULAR Recommendations for prevention and management of osteoporoticfractures(recommendation 6) 5 . EULAR Points to consider for monitoring (detection/prevention) comorbidities in inflammatoryrheumaticdiseases (point to consider 10) 6 . 2015 Recommendations for the management of polymyalgiarheumatica: a European League AgainstRheumatism/American College of Rheumatologycollaborativeinitiative (recommendation 9) 7 . BSR guidelines for the management of polymyalgiarheumatica (recommendation 6) Conclusion Current prominent rheumatology guidelines have insufficiently addressed the management of rheumatological diseases in GP. Additional studies ares needed to delineate specific guidelines for the management of geriatric patients with rheumatological diseases. References [1]OECD (2022), Elderlypopulation (indicator). doi: 10.1787/8d805ea1-en (Accessed on 27 January 2022) [2]Tutuncu Z, Reed G, Kremer JA. Do patients with older-onsetrheumatoidarthritisreceive less aggressivetreatment? Ann Rheum Dis. 2006 Sep;65(9):1226-9. Disclosure of Interests None declared